Health Education Research, Vol. 15, No. 4, 503,
August 2000
© 2000 Oxford University Press
Letters to the Editor |
Response to Kreuter and Skinner
Division of Cancer Control and Population Sciences, National Cancer Institute, Bethesda, MD 20892-7338, USA
I want to commend Matt Kreuter and Celette Skinner for their Editorial entitled `Tailoring: what's in a name?' (Kreuter and Skinner, 2000
).
I could not agree more with their argument that we need to agree on standard terminology with regard to tailoring. In the past few months, particularly in my role as the leader of a large program at the National Cancer Institute, I have been struck by the lack of consistency in behavioral science terminology.
In the basic sciences, a gene is a gene to everyone. However, in our field, we would define gene differently depending on who was measuring it. There might be multiple definitions and they would probably evolve over time. It is time to discipline ourselves to strive for shared language, especially in measurement but also in the descriptions of the types of interventions we use. Otherwise, it is very difficult to communicate within and across disciplines and to develop syntheses of our interventions.
Kreuter and Skinner's suggestion comes at a propitious time in the evolution of tailoring. When my colleagues and I developed the Clear Horizons program in 1990 and referred to it as `tailored to older smokers' (Rimer et al., 1994), we had no reason to suspect how different tailored interventions would be from what now are more appropriately labeled `targeted' interventions. Unfortunately, although we would now never call Clear Horizons a tailored program, in the evolution of terminology, the titles of our papers stand.
I commend the authors' attempts to encourage precision in our language. We must be able to communicate not only with each other but also with people who have little idea what behavioral interventions are in the first place. Imprecision is likely to confuse them further. One issue to resolve is the increasing use of the term `cultural tailoring' when what is usually meant is more akin to cultural targeting than tailoring.
While I might quibble over the wording Kreuter and Skinner have proposed (i.e. we need to allow the possibility that individual-level data are obtained from sources other than the person him or herself, e.g. from the medical record), I suggest that we endorse it in principle. In fact, I have been using this definition with minor modifications in recent articles about tailored communications.
Agreement upon tailoring and targeting terminology should be one step in a larger-scale effort to insert more precision into our language.
References
Kreuter, M. W. and Skinner, C. S. (2000) Tailoring, what's in a name? Health Education Research, 15, 1–4.
Rimer, B. K., Orleans, C. T., Cristinzio, S., Telepchak, J. and Keintz, M. K. (1994) Does tailoring matter? The impact of a tailored guide on ratings and short-term smoking-related outcomes for older smokers. Health Education Research, 9, 69–84.
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